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Aesthetic nurse injector Leslie Fletcher, RN, MEP-C, knows her way around a needle. She has worked with world-renowned, celebrity dermatologists and plastic surgeons who utilize dermal fillers such as Juvederm®, Restylane®, and Perlane® in their practices. Recognizing that these dermal fillers revolutionized how we address the signs of age, Leslie became determined to create a methodology that would maximize their potential. Well trained in medical science, including the bone, muscle, fat, and collagen structure that compose the facial armature, Leslie also looked into using the principles of architectural engineering, construction, and design for the rational to back her theories. These varied skills served as the foundation for her research and creation of the ArqueDerma Artistic Restoration Lift. Today, her patented technique is used by over 400 licensed ArqueDerma™ practitioners in North America and worldwide each year.

Tell us a bit about your background. How did you become an expert in cosmetic injectables?

In 2001, a colleague told me of a position in a plastic surgery office. Within a short time of employment, I knew I had found my passion. In a relatively new industry, I was able to blend my nursing degree, artistic creativity, and innovation in a specialty that was hungry for new ideas. Becoming an expert occurred gradually over time as I pursued my craft with passion and zeal. I took advantage of everything available to me to cultivate my expertise as an injectable nurse. I went to every conference, training, read every journal, and watched every webinar possible that promoted this goal. When considering a new technique to overcome an aesthetic obstacle, the research and development started not on my patients, but on myself. Though most of these trials had a positive effect, others were not as successful, such as the one that produced a lopsided grin, and were eliminated from my collection of new techniques. Eventually my training, experience, trials, and errors led me to the point of wanting to convey my knowledge and experience to mentor other injectors. This filled the gap that I sensed when I was learning this emerging craft. Feeling confident in my knowledge, I began to work in the role as a mentor to others utilizing my training. I quickly realized there was a whole new dimension of knowledge yet to be revealed, especially as I began my interaction with practitioners in other countries and with other products available there.

What inspired you to create the ArqueDerma™ technique?

Simply stated, I was dissatisfied with the current methods available that were ‘filling’ and not ‘fixing.’ It was as if a ‘puffy’ Band-Aid was put on the problem, instead of fixing the underlying cause. Patients I had been treating for years wanted more than just a ‘fill,’ they wanted a ‘lift.’ They believed in me, even before I believed in me. Comments were made such as, “You’re so creative, can’t you move this part of my face from down here to where it used to be?” This inspired my curiosity to look outside the box to fix this gravitational problem. With the highest regards to outcomes, I wanted to be able to offer my patients what they needed in a non-surgical way. I held to my standards, and postulated there must be a way to deliver those results to my patients. Similar to most inventions, ArqueDerma™ was born out of a necessity.

What sort of injectables do you use with the ArqueDerma™ technique?

All of the current FDA approved hyaluronic acids work beautifully for this technique, hydrating the skin, stimulating collagen, as well as suspending the lax tissue. Even though all of the hyaluronic acids work for the technique, I am determined to quantify certain aspects about the various hyaluronic acids that I see as advantageous to this technique. In order to do this, I have commissioned an independent research lab to study the characteristics of the various hyaluronic acids, such as Juvederm®, Perlane® and Restylane®. My primary goal is to determine which product has the greatest hydrating effect, as well as the optimum lift capacity. I hope to reveal the results of these various laboratory studies soon.

Who practices the technique and how can they learn about it?

Because of the patent, only practitioners licensed in ArqueDerma™ can perform, and market themselves as a licensed ArqueDerma™ practitioner. We take the training of this revolutionary technique very seriously. In order to acquire a license one must participate in an intense 8-hour training course with hands on coaching using the technique on a live patient. This technique is so different, and counterintuitive that it takes this type of intense training to grasp a hold of it. Currently we have over 400 practitioners in 6 different countries licensed in the technique. The trainings are held in various parts of the world, based on request. Information about upcoming trainings can be found at ArqueDerma.com.

What three questions should a patient ask a medical professional before having filler or toxin injections?

Medical aesthetics is an exciting and busy space, making finding a trusted individual to treat you challenging. I think word of mouth is certainly important and one should always make sure who they visit has a current license. Here are a few important questions I suggest patients ask to get the outcome they desire:

When was the last training they attended? Medical aesthetics is a very dynamic, and relatively new industry. Your practitioner should be staying abreast of all the advancements in techniques that have occurred since this industry’s inception.

What is their specialty? Do they offer a vast menu of treatments? Are they focused on mastering the art of injectables?

What is their design aesthetic? Do you and your practitioner have a similar view of beauty, and a similar plan to get you to your goals and desired outcomes?

What is next in the field of cosmetic injectables? Are there any new products coming down the pipeline that you are particularly excited about?

I am very excited about a product that is already approved in Europe, and should arrive here next year sometime. Allergan’s newest hyaluronic acid named Voluma® is thicker, and more substantial, than its younger siblings Juvederm® Ultra, and Ultra plus. I have been privileged to test this product out, and have included it in some of my independent research. I’m also very anxious to see a topical alternative to Botox® make its way through clinical trials. I think there will be great indications for a more superficially administered type of neuromodulator to enhance the skin, tighten the pores, decrease sebum production, as well as redness and flushing all without the hassle of needles. In addition to products, I believe there are many more innovations with techniques to be discovered in aesthetic medicine. All it takes is a little creativity and the courage to try something a little outside the box.